Amber Rae Madume, BA, BS, BHRS, MS

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

4232 Issued in MN

Practice address

6040 Earle Brown Dr Ste 100
Brooklyn Center, MN 55430-2561

Phone

(651) 313-8080

NPI assigned

Jun 28, 2011

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other names 1

• Amber Rae Wooten Former name

Medicare fee-for-service enrollment

Enrolled in MN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Vantage Mental HealthGroup PAC ID 4587104815, 29 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Bachelor of Arts, Bachelor of Science, Master of Science

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Vantage Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Oak Park Heights, MN
  • NPI 1538990288
  Medicare reassignment Care Compare group NPD
• By Design Behavioral Health, PLLC

  • Professional Counselor
  • Austin, TX
  • NPI 1043003429
  NPD Authorized official
• Nystrom & Associates, LTD

  • Clinical Social Worker
  • New Brighton, MN
  • NPI 1396750188
  NPD
• Collaborative Psychiatric Services LLC

  • Psychiatry Physician
  • Oak Park Heights, MN
  • NPI 1699525857
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1309219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1710979200000",
    "number": "1780970715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 LACEY LN",
            "address_2": "UNIT B",
            "city": "POTEAU",
            "state": "OK",
            "postal_code": "749535551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6040 EARLE BROWN DR STE 100",
            "city": "BROOKLYN CENTER",
            "state": "MN",
            "postal_code": "554302561",
            "telephone_number": "651-313-8080"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13597 SE 202nd Rd",
            "address_purpose": "LOCATION",
            "city": "Talihina",
            "state": "OK",
            "postal_code": "745716003",
            "country_code": "US",
            "telephone_number": "918-567-2905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MADUME",
        "first_name": "AMBER",
        "middle_name": "RAE",
        "credential": "BA, BS, BHRS, MS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-06-28",
        "last_updated": "2024-03-21",
        "certification_date": "2024-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225C00000X",
            "taxonomy_group": "",
            "desc": "Rehabilitation Counselor",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "MN",
            "license": "4232",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "AMBER",
            "last_name": "WOOTEN",
            "middle_name": "RAE",
            "credential": "BA, BS, BHRS",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Norman Martin Lunde, M.D.
• David Joseph Lutz, DC
• Abigayle Luy-Taylor
• Salahudin Maalim
• Randy J Mack, RPH
• Cortney Kay Magyarics
• Hudefa Mahad
• Subhashini Mahipathi, M.D.
• DO H Mai, DDS
• Malaika Health and Wellness LLC

• Mental Health Counselor in Brooklyn Center, MN
• Providers in Brooklyn Center, MN by specialty
• Mental Health Counselor in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.